The DAta Food NEtworking (DAFNE) project

Transcription

1 The DAta Fd NEtwrking (DAFNE) prject EUROPEAN FOOD AVAILABILITY DATABANK BASED ON HOUSEHOLD BUDGET SURVEYS Grant Agreement number S between the Cmmissin f the Eurpean Cmmunity and the Natinal Kapdistrian University f Athens (NKUA), Greece

2 TABLE OF CONTENTS Page List f participants 3 A. Intrductin 5 The DAFNE initiative 6 The DAFNE III prject 7 B. Material Methds 8 Material 8 Methds 8 Incrpratin f raw HBS data f each participating cuntry in the central database Harmnisatin f the fd, demgraphic and sciecnmic infrmatin cllected in the HBS f the participating cuntries The DAFNE fd classificatin scheme 12 The DAFNE classificatin scheme fr scidemgraphic data Estimatin f the average daily fd availability fr the verall ppulatin and sci-demgraphic grups C. Results 17 D. Organisatin and activities f the prject 23 Meetings 23 Bilateral Meetings 25 Activities f the DAFNE III prject 26 Disseminatin f research results 27 List f references 31 List f Annexes 33 2

3 LIST OF PARTICIPANTS BELGIUM Dr. Remaut de Winter A.M. Dept. f Fd Technlgy and Nutritin, Faculty f Agricultural and Applied Bilgical Sciences, University f Gent. Mr. Perez Cuet Eulert FA. Dept f Fd Technlgy and Nutritin, Faculty f Agricultural and Applied Bilgical Sciences, University f Gent. FRANCE Dr. Vlatier J.L. Unité Observatire de Cnsmmatin Alimentaire, Fd Safety Agency (AFFSA). Ms. Maffre J. Unité Observatire de Cnsmmatin Alimentaire, Fd Safety Agency (AFFSA). GREECE (crdinating centre) Dr. Trichpulu A. (c-rdinatr) Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Ms. Antniu A. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Mr. Chlptsis Y. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Dr. Naska A. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Ms. Oiknmu E. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Mr. Tsitas K. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. IRELAND Ms. Friel S. Natinal Nutritin Surveillance Centre, Department f Health Prmtin, Natinal University f Ireland. Mr. Daltn J. Husehld Budget Survey, Central Statistics Office. 3

4 ITALY Dr. Turrini A. Natinal Institute fr Fd and Nutritin Research (INRAN),Rme. Dr. Barcherini S. Italian Statistical Office. Dr. Martines S. Natinal Institute fr Fd and Nutritin Research (INRAN),Rme. NORWAY Dr. Trygg K Institute fr Nutritin Research, University f Osl. Mr. Mrk E. Statistics Nrway, Osl. Ms. Lund-Iversen K. Institute fr Nutritin Research, University f Osl. PORTUGAL Dr. Vaz de Almeida M.D. Faculty f Fd and Nutritin Sciences, Prt University Ms. Rdrigues S. Faculty f Fd and Nutritin Sciences, Prt University. SPAIN Dr. Mreiras O. Department f Nutritin, Faculty f Pharmacy, Cmplutense University, Madrid Ms. Cuadrad C. Department f Nutritin, Faculty f Pharmacy, Cmplutense University, Madrid UNITED KINGDOM Dr. Nelsn M. Department f Nutritin and Dietetics, King s Cllege, University f Lndn. Mr. Rimmer D. Department f Envirnment, Fd and Rural Affairs (DEFRA). Ms. Burr S. Department f Nutritin and Dietetics, King s Cllege, University f Lndn. 4

5 A. Intrductin With the aim t imprve health and related infrmatin available in the EU Member States and t develp and imprve systems f data cllectin, a prgramme f Cmmunity actin n health mnitring was set up in The bjective f the prgramme was t cntribute t the establishment f a Cmmunity Health Mnitring System, which makes it pssible t: measure health status, trends and determinants thrughut the Cmmunity facilitate the planning, mnitring and evaluatin f Cmmunity prgrammes and actin; prvide Member States with apprpriate health infrmatin t make cmparisns and supprt their natinal health plicies. Mnitring dietary patterns are amng the prime cntributins f nutritinal science in the nutritinal epidemilgy develpment, the frmulatin f dietary recmmendatins, in the planning and implementing natinal fd, nutritin and agricultural plicies. Currently, internatinal cmparisns f dietary expsures are mstly based n fd rather than nutrient intake. The lack f cmpatibility f fd cmpsitin data frm varius cuntries (1) and findings that, in several instances, fd cmpnents act synergistically t exert their effects lead t an expansin f current research twards studying patterns f fd intake (2, 3, 4). The fd data used fr internatinal cmparisns are ften derived frm: a) fd balance sheets (FBS), prviding infrmatin n fd supply at the ppulatin level b) husehld budget Surveys (HBS), which cllect data n fd availability within a natinally representative sample f husehlds and c) specifically designed individual nutritin surveys (INS), prviding infrmatin n the fd-intake f free-living individuals, ver a specified time perid. The FBS data are useful when cnducting cmparisns n the adequacy f fd supply and fr fllwing ver time crude dietary changes. The individual surveys, when intakes f the subject are recrded as adequately as pssible, are expected t prvide evidence n the fd quantities cnsumed. Nevertheless, when internatinal cmparisns are undertaken, the 5

6 differences in study design and analysis f the varius surveys reduce the cmparability f the results (5). Cmparable between cuntries infrmatin n fd availability can be prvided by data cllected in the HBS. The HBS can be thught f ccupying a psitin between the FBS and the INS. Like fd balance sheets, the HBS allw between cuntry cmparisns at a regular basis but, mving frm ttal ppulatin t husehld level, the HBS can prvide a mre detailed descriptin f the dietary chices f the ppulatin, as well as f ppulatin sub-grups (6). The DAFNE initiative The DAFNE initiative aims at creating a cst-effective Eurpean databank, based n the fd, sci-ecnmic and demgraphic data frm natinally representative HBS (7). Since 1987, the Natinal Nutritin Center in Athens, Greece, has rganized a series f wrkshps, seminars, and pilt research prjects aiming at the develpment f the mst apprpriate way f using fd and related data frm Husehld Budget Surveys. In , this apprach was granted financial supprt by the Eurpean Cmmissin thrugh the DAFNE I and II prjects which, upn cnclusin, prvided a fd database with cmparable HBS data frm 10 Eurpean cunties (8,9). After the develpment f the DAFNE databank and in an attempt t better understand the limitatins f the HBS data and n hw we shuld deal with them, the wrk undertaken in the cntext f the DAFNE initiative was aiming at cmparing data frm HBS, retrieved frm the DAFNE databank, with data frm INS (the FAIR prject: Cmpatibility f the husehld and individual nutritin surveys in Eurpe and disparities in fd habits ). Cmparisns f the HBS and INS data fr 4 Eurpean cuntries shwed that husehld budget and specially designed nutritin surveys are, given the limitatins present in bth, cmparable (10). Thus, the DAFNE databank can serve as a tl fr the identificatin f disparities in fd habits amng Eurpean cuntries and their sci-demgraphic determinants. 6

7 The DAFNE III prject The Eurpean Fd Availability Databank based n Husehld Budget Surveys DAFNE III prject was aiming at updating the DAFNE databank, by including additinal datasets frm six already participating Eurpean cuntries (Belgium, Greece, Nrway, Republic f Ireland, Spain and the United Kingdm) and als by integrating several HBS datasets (cllected in cnsequent time perids in each cuntry) frm France, Italy and Prtugal. The thus develped databank can serve as a tl fr: The fllw-up f trends in nutritinal practices, based n cmparable and regularly updated infrmatin The identificatin f ppulatin sub-grups whse dietary habits are nt favrable accrding t the current scientific knwledge n the assciatin f diet and health and The utlining f preventive interventins in rder t supprt cnsumer chices twards a healthy nutritin. The ultimately develped databank was designed t be integrated in the Eurpean Unin Public Health Infrmatin Netwrk (EUPHIN) f the Eurpean Cmmissin and ptentially t ther infrmatin systems, prviding thus a cst-effective nutritin mnitring tl. 7

8 B. Material - Methds Material The DAFNE databank frmulated upn cnclusin f the DAFNE III prject includes data frm 44 HBS f eight EU Member States and Nrway. The year and the prcedures f data cllectin and strage, the methdlgical characteristics and ther general infrmatin regarding the integrated datasets are presented in tables included as Annex I. The infrmatin included in Annex I summarises the results f an inventry disseminated t all data prviders, with the bjective t understand the methdlgical attributes f each dataset and t evaluate the feasibility f cmparisns between the participating cuntries. Methds The tasks undertaken in the cntext f the DAFNE III prject can be summarized in the fllwing (Figure 1): Incrpratin f the raw HBS data f each participating cuntry in the central database, perating at the crdinating centre. Harmnisatin f the fd, demgraphic and sci-ecnmic infrmatin cllected in the HBS f the nine participating cuntries. Estimatin f the average daily fd availability fr the verall ppulatin and sci-demgraphic grups. 8

9 Figure 1: The Husehld Budget Survey data prcessing and analysis in the cntext f the DAFNE initiative DAFNE DAta Fd NEtwrking Fd Databank based n Husehld Budget Surveys (HBS) HBS data prcessing and analysis Data management and cleaning Internal validatin: cmparisn f the derived values with published data DAFNE fd classificatin system Definitin f cmparable categries f scidemgraphic data Statistical analysis Summary statistics n fd availability Develpment f mdels fr the estimatin f fd availability at the individual level results by level f educatin verall means results by lcality results by ccupatin results by husehld cmpsitin External validatin: cmparisn f HBS and individual-based nutritin survey results

10 Incrpratin f raw HBS data f each participating cuntry in the central database All datasets, tgether with their file descriptins, were received in the Athens centre. In the majrity f the cases, data were stred in ASCII files, with size and structure varying due t different sample sizes and variables prvided. It shuld hwever be nted that all datasets included infrmatin at least n the fllwing variables: 1. General infrmatin - husehld identificatin number - trimester f participatin 2. Nutritinal infrmatin - fd cde - ttal fd expenditure (fd expenditures utside the husehld included) - expenditure per fd item - amunts per fd item 3. Sciecnmic infrmatin - degree f urbanisatin f husehld (urban, rural, semi-urban) - name f gegraphical area where the husehld is situated - husehld size - husehld cmpsitin - age and gender f husehld head and members - relatinship f husehld members with the husehld head - husehld dispsable incme (net incme) - husehld ttal expenditure - ccupatin / emplyment status / ecnmic activity f husehld head and members - educatin f husehld head and members - incme f husehld head - medical expenses data The well understanding and crrect reading f the data by the DAFNE crdinating 10

11 team is evaluated thrugh samples f randm husehlds which are sent t each cuntry fr crss-checking. Befre finalising the data integratin in the central DAFNE database, the Athens team prceeds t checking f the data cnsistency by: - estimating the range f values - evaluating the agreement between verlapping variables (e.g. age given in discrete years and in age grups) - crss-tabulating categrical variables with cnnected cntent (e.g. the age f the husehld head and his/her emplyment status). - identifying and estimating missing data fr the variables that will be cnsidered in the analysis. The raw DAFNE data are stred and maintained in a Micrsft SQL Server 2000 DBMS n a Windws 2000 Server Operating System. Fr the verificatin and cleaning f the data, an existing tl (visual FxPr) is used. The data is stred per cuntry/per year (in which the husehld budget surveys have been carried ut). The raw DAFNE data can be queried by users wh lgin thrugh the Department f Hygiene and Epidemilgy s VLAN. Any user, except the Administratr, has nly view privileges. 11

12 Harmnisatin f the fd, demgraphic and sci-ecnmic infrmatin cllected in the HBS f the participating cuntries. The DAFNE fd classificatin scheme The develpment f a fd classificatin system that wuld allw internatinal cmparisns f dietary patterns is a central element in the develpment f a Eurpean fd databank. In this curse f actin, varius issues had t be cnsidered; the mst prminent amng them referring t the variant level f detail in which HBS fd data were recrded in the cuntries. A descriptin f the prblems and the actins taken t tackle them is prvided in the manuscript entitled The DAFNE initiative: The methdlgy fr assessing dietary patterns acrss Eurpe using husehld budget survey data, published with the supprt f DG-SANCO in the cntext f the DAFNE III prject (11). The end result f this prcess was the DAFNE fd classificatin scheme (Table 1), which allws the classificatin f fd data cllected in different Eurpean cuntries int 56 detailed subgrups. These subgrups can be further aggregated at varius levels ending up at 15 main fd grups. The Athens team has been clsely cllabrating with nutritinists frm each participating cuntry in classifying the recrded fd variables under this cmparable between cuntries scheme. All fd classificatins, separately fr each cuntry and survey year, are included in Annex II. In sme cases, the expenses related t a small number f fd cdes were nly recrded. In their vast majrity, these fd cdes refer t fd items nt usually purchased by the ppulatin and their absence des nt impair general cnclusins n the natinal fd habits In the case f France, data cllected thrugh the 1985 and 1991 HBS refer t quantities f fd available in the husehld, tgether with expenses incurred. The situatin was hwever different in the 1995 survey, as fd expenses were nly recrded. The 1995 expenditure data were cnverted using a price per unit weight vectr, built frm the Taylr Nelsn Sécdip husehld panels, but because f the different methdlgy applied in the estimatin f fd quantities, French HBS data cllected in 1985 and 1991 are nly presented in this reprt. 12

13 Table 1: The DAFNE fd classificatin system CEREALS AND CEREAL PRODUCTS Bread and rlls Rice and ther cereals Flur Pasta Cereal prducts and bakery prducts (grains, flur and pasta excluded) MEAT AND MEAT PRODUCTS RED MEAT Prk meat (fresh and frzen) Beef, veal and calf meat (fresh and frzen) Red meat, ther than prk r veal (fresh and frzen) POULTRY (fresh and frzen) OFFALS (fresh and frzen) CANNED MEAT AND MEAT PRODUCTS MEAT DISHES FISH AND SEAFOOD Fish (fresh, frzen and prcessed) Seafd Fish dishes MILK AND MILK PRODUCTS Milk Cheese Milk prducts (milk and cheese excluded) EGGS TOTAL ADDED LIPIDS LIPIDS OF ANIMAL ORIGIN Butter Animal fat (butter excluded) LIPIDS OF VEGETABLE ORIGIN Vegetable fat Margarine Vegetable fat (margarine excluded) Vegetable ils Olive il Seed ils POTATOES AND OTHER STARCHY ROOTS PULSES VEGETABLES FRESH VEGETABLES Green leafy vegetables (cabbage excluded) Cabbage Tmates Carrts Onins and garlic Other fresh vegetables PROCESSED VEGETABLES NUTS FRUITS FRESH FRUITS Apples Citrus Bananas Grapes Plums Berries Apricts and peaches Cherries and sur cherries Pears Other fresh fruits PROCESSED FRUITS FRUIT AND VEGETABLE JUICES Fruit juices Vegetable juices SUGAR AND SUGAR PRODUCTS Sugar Sugar prducts NON-ALCOHOLIC BEVERAGES STIMULANTS Cffee Tea and infusins Cca MINERAL WATER SOFT DRINKS ALCOHOLIC BEVERAGES Wine Beer Spirits

14 The DAFNE Classificatin Scheme fr sci-demgraphic data Thugh several sci-demgraphic characteristics are recrded in the HBS and many f them are included in the final rster f variables t be studied, fcus was put n the lcality f the dwelling, the educatinal status and the ccupatin f the husehld head, and n the husehld s cmpsitin. Variables related t the abve characteristics and recrded at natinal level were classified under cmmn between cuntries grupings, which were frmed thrugh the establishment f peratinal criteria, iterative crss-cding, as well as several wrking grup meetings and bilateral visits t address specific prblems. Mre specifically: Lcality Using varius criteria (e.g. number f inhabitants, number f electrs, ppulatin density) the fllwing three categries f lcality were frmed: urban, semi-urban and rural. The effect f lcality n the husehlds fd chices was nt studied in the Greek HBS data since, fr annymity reasns, the Greek Statistical Office culd nt prvide the variable infrmatin that wuld allw the classificatin under the abve grups. Educatin f husehld head Thugh differences in the natinal educatinal systems d exist, data n the educatin f husehld head culd be classified under five cmparable categries: Illiterate / Elementary educatin nt cmpleted, Elementary educatin cmpleted Secndary educatin nt cmpleted Secndary educatin cmpleted and Cllege/University. Amng the cuntries under study, data n the educatinal status f the husehld head and members was nt rutinely cllected in the Republic f Ireland and the United Kingdm. 14

15 Occupatin f husehld head Occupatin reflects a number f characteristics including educatin, incme and physical activity. If prperly harmnized, it can prvide a suitable basis fr cmparisn f dietary practices. In the DAFNE III prject, ccupatin was classified under the fur categries belw, based n the ccupatinal status and the prfessin, if emplyed, f the husehld head: Nn-manual Manual Retired Other (students, husewives, unemplyed and invalid persns). The last cmpsite categry bviusly presents several prblems, as it cmprises individuals with different activity levels and varying incmes. Ways f disaggregating it are still being cnsidered. Regarding retired persns, it has been suggested that they shuld be divided int retired-previusly manual and retired-previusly nn-manual. Husehld cmpsitin Thugh nt frequently cnsidered in dietary analyses, husehld cmpsitin can have a substantial influence n nutritinal chices and practices. With children defined as being up t 18 years ld, adults being between 19 and 65 years f age and individuals mre than 65 years ld cnsidered as elderly, and with an intended distinctin between single and ther husehlds, eight categries were frmed: single adult husehlds, husehlds f tw adult residents husehlds f ne adult resident and children (lne parent), husehlds f tw adult residents and children, husehlds f adult and elderly residents, husehlds f children, adult and elderly residents, single elderly husehlds and husehlds f tw elderly residents. All classificatin schemes fr the sci-demgraphic variables under study and separately fr each cuntry and survey year are included in Annex III. 15

16 Estimatin f the average daily fd availability fr the verall ppulatin and sci-demgraphic grups. Fr each f the DAFNE cuntries, fd availability per capita per day was calculated by dividing the husehld availability by the prduct f the referent time perid and the mean husehld size. After indicatin and advice prvided by the natinal data supplier, a weighting factr was incrprated in the frmula whenever necessary t accmmdate the sampling scheme. The verall average availability per day per persn f the cmparable fd items r grups, as well as the average (per day, per persn) availability fr husehlds belnging t different sci-demgraphic levels were calculated. It shuld hwever be nted that individual availability was estimated withut making allwances fr the prprtin f fd that was edible and under the assumptin f equal distributin f fd within the husehld and during the survey perid. C. Results Tables presenting the mean availability f the 15 DAFNE fd grups by cuntry and year f survey are included as Annex IV. In the fur Mediterranean cuntries (Greece, Italy, Prtugal and Spain), data are additinally prvided n trends in the availability f live il. In the same Annex, mean availability values by the fur scidemgraphic characteristics under study are als presented fr each cuntry and survey year. Graphical presentatins f changes in the daily individual fd availability in the nine participating cuntries are included in Annex V. Finally, trends in the availability f fur fd grups with public health interest (milk and milk prducts; meat and meat prducts; vegetables; fruits) are als presented in the frm f bar charts in Annex V. Frm these fur, ne fd grup is selected in each cuntry and is further presented in relatin t the educatinal level f the husehld head. The fd selectin was generally made n the basis f apparent differential effect f educatinal level t fd availability ver time. 16

17 Lastly, changes f fd availability ver time and the effect f sci-ecnmic characteristics n fd chices are belw summarised fr each f the 15 main DAFNE fd grups. Eggs: In all cuntries, the availability f eggs decreased with time. Urban husehlds, with heads f higher educatin r ccupied in nn-manual prfessins recrded lwer mean availability values in all survey years. The nly exceptin stands fr the Prtuguese husehlds, amng which, urban, nn-manual husehlds, r thse f upper educatin recrded the higher mean daily availability f eggs. Ptates and ther starchy rts: The highest ptat availability was recrded in Prtugal (230 g/p/d in 1995) and Ireland (197 g/p/d in 1994 and 186 g/p/d in 1999) and the lwest in Italy (76 g/p/d in 1996). Over time, the daily availability f ptates and ther starchy rts decreased in all cuntries. With respect t the effect f educatin, ptat availability decreased as the educatinal level f the husehld head imprved and, higher values were recrded amng manual husehlds. Given that ptat is cnsidered amng the staple fds f the Irish ppulatin, it shuld further be nted that manual husehlds in Ireland recrded a higher decrease in ptat cnsumptin ver time, when cmpared t their nn-manual cunterparts. With the exceptin f Italy where ptat availability increased as ne mves frm rural t urban areas, in all ther cuntries the lwer values were recrded in the urban husehlds. Pulses: Pulses, plant fds f high fibre and prtein cntent, can generally be cnsidered as a fd preferably cnsumed in Suth Eurpe, since in Spain, Greece and Prtugal the mean pulses availability exceeded 10g/p/d, while in Central and Nrth Eurpe the availability values barely exceeded 1g/p/d, with Belgium recrding in mid nineties 0.2g/p/d. In all cuntries hwever, pulses availability decreased with time. In general, even in cuntries where the cnsumptin f pulses is nt ppular, husehlds f lw educatinal level recrded higher values in all survey years. Particularly in Greece and Prtugal the highest pulses cnsumers resided in rural areas r were f lw educatin, reflecting prbably the adherence f these ppulatins t 17

18 traditinal eating patterns. Interestingly enugh, the cnsumptin f pulses was nt ppular in Italy, which recrded in mid nineties apprximately the same availability values with France (4.1g/p/d in Italy and 4.9 g/p/d in France). Nuts: Nuts are amng the few fd items whse availability either increased substantially (Belgium), mderately (Greece, Nrway, the Republic f Ireland and United Kingdm) r remained stable (France, Italy and Prtugal) ver time. In general, nuts seem t be preferably cnsumed by individuals f higher educatin r nn-manual prfessins, r individuals residing in urban areas, and these bservatins seem t persist ver time. An exceptin shuld hwever be nted in Greece, where lw educated husehlds substantially increased their nut availability in the 20-year perid under study, thus taking recently the lead frm their highly educated cunterparts. Cereals and cereal prducts: In agreement t the majrity f the fd grups under study, the availability f cereals and f their prducts (including bread, rusks, pizza, and ther bakery prducts) is als decreasing ver time. Tw exceptins stand fr Belgium, where cereal availability increased between 1987/88 and 1999 by 18 g/p/d and Ireland, where n change has been nted during the same perid. In terms f patterns f cereal intake, as expected, Italy leads with 335 g/p/d (1996) and the United Kingdm trails with 199g/p/d (1999). In general, individuals f elementary educatin r manual prfessins r residing in rural areas recrded the higher values f cereal availability within their husehlds and this bservatin persists ver the studied perid. Milk and milk prducts: Different patterns were bserved with respect t the daily individual availability f milk and milk prducts. In late nineties, the highest availability values were recrded in the Republic f Ireland (480 g/p/d) and Nrway (386 g/p/d) and the lwest in Belgium (255 g/p/d). In terms f time trends, the daily availability increased in Belgium, France, Greece, the Republic f Ireland and Prtugal; nly a marginal increase was nted in Italy and a decrease in Nrway, Spain 18

19 and the United Kingdm. In general, high milk and milk prduct availability was recrded in husehlds f rural areas (except frm Prtugal), r husehlds f higher educatin (exceptins are France and Italy) r husehlds whse heads were emplyed in nn-manual prfessins (except frm France, Ireland Nrway and the United Kingdm). Our finding that milk and milk prduct availability increased with nn-manual prfessins r as the educatinal level imprved agrees with previus findings reprting that cheese is preferably cnsumed by individuals f cllege and university educatin (12). Generally, n change was bserved n hw scidemgraphic factrs affect the availability f milk and milk prducts ver time. Meat and meat prducts: Based n data cllected in late nineties, the lwest meat and meat prduct availability was recrded in Nrway (126 g/p/d) and the highest in the Republic f Ireland (166 g/p/d). With respect t time trends, meat availability decreased in the studied time perid, with the exceptin f Nrway (+5 g/p/d), Prtugal (+20 g/p/d) and the Republic f Ireland (+33 g/p/d). In all cuntries but Nrway and Prtugal, residents f urban areas, r f high educatinal level reprted purchasing smaller amunts f meat and prducts fr husehld cnsumptin. Husehlds with heads emplyed in manual prfessins recrded higher purchases f meat and meat prducts; whereas in Greece and again in Nrway and Prtugal n difference was nted n meat availability within manual and nn-manual husehlds. Vegetables (fresh and prcessed): Accrding t HBS data cllected in late nineties, Greece recrded the highest vegetable availability within the husehld (271 g/p/d) and Nrway the lwest (109 g/p/d). Fr the remaining cuntries, vegetable availability varies between 150 g/p/d (in Ireland, the UK and Prtugal) and 180 g/p/d (France and Italy). Given current recmmendatins fr at least 3 prtins f vegetables (apprx. 250 g/p/d) n a daily basis, Eurpeans are still remte frm meeting this target. If we further cnsider that the abve values refer t vegetable purchases, which are generally higher t actual intake, the deficit is mre prnunced. In recent years hwever, vegetable availability is generally n the rise in Nrthern and Central Eurpe. Suthern Eurpean cuntries n the ther hand, have recently recrded a 19

20 reductin in husehld vegetable purchases, with the sle exceptin f Greek husehlds, which recrded an increase between 1987 and In general, high vegetable cnsumers reside in urban areas, r are f higher educatin, r exercise nnmanual prfessins. It shuld further be added that the highest increase in vegetable availability in Nrthern and Suthern Eurpe was mainly nted fr the trend-leading highly educated husehlds. The case f Greece shuld hwever be nted, with vegetable availability being higher amng husehlds f elementary educatin, which, in additin, increased their vegetable availability between mre than their highly educated cunterparts. Fish and seafd: Prtugal is leading fish availability with 85g/p/d, fllwed by Spain (74 g/p/d), Nrway (50 g/p/d) and Greece (45 g/p/d), while the lwest fish and seafd availability was recrded in the Republic f Ireland (13 g/p/d). N large variatins have been bserved in fish availability ver time, with the sle exceptins f Prtugal and Greece, where daily availability values increased by apprximately 10 g during recent years. Urban areas recrded higher fish cnsumptin, reflecting prbably the recent imprvement f fd availability in urban markets. In general, fish availability was higher amng husehlds f nn-manual prfessins, while it was nt fund t differ between different educatin attainment levels. The nly exceptins are Nrway and Greece, where fish availability decreased as the educatinal level f the husehld head imprved. It shuld further be nted that, in recent years, the Greek lw educated husehlds had the biggest increase in fish availability, while in Nrway highly educated husehlds increased mre than the lw educated nes. Fruits (fresh and prcessed): Fruits, tgether with vegetables, are the tw fd grups mst frequently mentined fr their beneficial attributes. In the case f fruits, all the Mediterranean cuntries clearly lead the way with daily availability exceeding the WHO recmmendatins f at least 2 prtins (apprx. 150 g) f fruit per day. The United Kingdm and the Republic f Ireland are trailing with 106g/p/d and 101 g/p/d respectively. Nevertheless, in all cuntries but Ireland and the united Kingdm fruit availability was decreasing with time. The highest fruit cnsumers were fund in 20

21 urban areas, were f cllege r university educatin, r were emplyed in nn-manual prfessins. This pattern remains unchanged ver the last 15 years, prbably indicating the success f campaigns t increase fruit cnsumptin amng these ppulatin sub-grups. Ttal added lipids: The added lipid grup includes all added fats (e.g. butter, margarine) and ils (live il and seed ils). As expected the highest lipid availability was nted in Greece (84 g/p/d), Italy (63 g/p/d) and Spain (59 g/p/d), with live il being the predminant added lipid. In all cuntries, lipid availability has either remained steady r decreased, with the mst marked decrease being nted in the Republic f Ireland (-21 g/p/d). Althugh the type f lipid cnsumed is different in the varius Eurpean regins, in all cases and thrugh different survey years, lipid availability is higher in rural areas and amng husehlds f elementary educatin, prbably indicating that high lipid availability may be related t traditinal eating patterns. Alchlic beverages: The lack f infrmatin n meals and beverages cnsumed utside the husehld is expected t impair bservatins related t the alchlic beverage intake. It shuld thus be cnsidered, when interpreting HBS data, that values n alchl intake are nly related t husehld availability. In this cntext, the highest availability values were recrded in Italy (149 ml/p/d) and France (114 ml/p/d) and the lwest in Greece (48 ml/p/d) and the Republic f Ireland (40 ml/p/d). N cnsistent pattern can be bserved n hw the availability f alchlic beverages varies with time. Hence, the availability f alchlic drinks within the husehld has increased in Belgium, Greece, Nrway, the Republic f Ireland and the United Kingdm, while it decreased in France, Italy, Spain and Prtugal. In the last 20 years, alchlic drinks have generally been mre available in rural husehlds, r husehlds with heads f elementary educatin; while n cnsistent pattern can be bserved n hw prfessin (manual vs. nn-manual) affects the availability f alchlic drinks within the husehld. 21

22 Nn-alchlic beverages: In accrdance t alchlic beverages, due cautin is required when interpreting data n the daily availability f nn-alchlic beverages (including sft drinks, mineral water, cffee and tea) at husehld level. In mst f the cuntries, the availability f nn-alchlic beverages has increased ver the studied time perid. As cffee, tea and similar infusins are included in the gruping, United Kingdm is leading the availability (923 ml/p/d), fllwed by Italy (824 ml/p/d) and Nrway (720 ml/p/d). With respect t lcality, in Nrthern Eurpe nn-alchlic beverage availability generally increased in rural husehlds, whereas the ppsite trend was bserved fr Central and Suth Eurpe. Between cuntries and survey years, n cnsistent pattern f the assciatin f educatin t nn-alchlic beverage availability was bserved; while in mst f the cuntries the availability f nnalchlic beverages was higher amng manual husehlds. Sugar and sugar prducts: The higher daily availability f sugar and sugar prducts was recrded in Nrway (79 g/p/d), the Republic f Ireland (61 g/p/d) and Italy (49 g/p/d). In respnse t current nutritinal trends, mst f the cuntries recrded a decrease in the availability f these prducts ver time. In all cases, sugar and sugar prduct availability was higher amng rural husehlds, f elementary educatin, r manual prfessins. Over time, the pattern described abve remained unchanged. Juices (fruit and vegetable): Because f the increased imprtance fruit and vegetable juices gain in cnsumers preference, the DAFNE team decided t separately address this beverage grup. In general, the availability f fruit and vegetable juices increased during the studied time perid. Hwever, the range f availability values is substantially large and ranges between 1.6 ml/p/d in Prtugal and 57 ml/p/d in the Republic f Ireland. It shuld further be nted that cuntries which were recrded as higher fruit cnsumers reprted lwer juice cnsumptin. In terms f sci-ecnmic disparities, in all cuntries and survey years, juices were preferably cnsumed by highly educated individuals, r individuals exercising nn-manual prfessins. 22

23 D. Organisatin and activities f the prject The prject was crdinated by the Unit f Public Health Nutritin f the Department f Hygiene and Epidemilgy, Medical Schl University f Athens. Five plenary meetings tk place in the curse f the prject and five bilateral meetings were undertaken between the crdinating center and participating cuntries t address cuntry-specific prblems. Summaries f the prject s and bilateral meetings are given belw. The minutes f the plenary meetings and the reprts f the bilateral meetings are included as Annex VI. Meetings I. First Plenary Meeting. March 26 th 2000, Pamplna Spain. The prject crdinatr presented an verview f the prject s bjectives and details n the prject s tasks. Participants ffered t prvide, where feasible, mre datasets than initially planned. Methdlgical issues referring t the estimatin f quantities frm expenses and the calculatin f the mean fd availability were als discussed. Participants were finally intrduced t the classificatin schemes f fd and scidemgraphic data, as these were develped in the cntext f the previus DAFNE prjects. II. Secnd plenary meeting. Nvember 3 rd -4 th 2000, Athens, Greece. Issues related t data prvisin and unclear file descriptins were discussed. After the first attempts t apply the classificatin schemes, participants discussed specific issues related t the applicatin f density and ther dietary cnversin factrs and t the classificatin f ambiguus fds. Since the cmpsitin f the husehld and the ccupatin f the husehld head were fr the first time studied and included in the analysis, discussin was fcused n devising the cmparable between cuntries classificatin grups fr these variables. Discussins were further referring t issues related t the estimatin f fd availability and t the analysis n trends. 23

24 III. Third plenary meeting. April th 2001, Premises f the Fd and Agriculture Organisatin (FAO), Rme Italy. Participants finalised the fd and sci-ecnmic classificatin schemes fr the nine participating cuntries and discussed issues related t the analysis f the data. The meeting was attended by FAO Officials actively invlved in the explitatin f fd cnsumptin data in already existing datasets, as is the case f the fd data cllected in the husehld budget surveys. The FAO Officials prvided their advice, cmments and suggestin thrughut the curse f the meeting and further presented the FAO prgramme n the use f fd cnsumptin data frm husehld incme and expenditure surveys. IV. Furth plenary meeting. August 31 st - September 1 st 2001, Institute f Nutritin, Vienna, Austria. The wrk schedule fr the last mnths f the prject was set, in rder t finalise the integratin f the raw data in the DAFNE database, the data analysis and the cmpilatin f the natinal reprts. Participants further decided n the frmat f the natinal reprts and n the prject s publicatin strategy. Finally, discussin fcused n hw the liaisn f the DAFNE prject with EUROSTAT culd be imprved. V. Final plenary meeting. December 2 nd -3 rd 2001, Brussels, Belgium. The prject crdinatr presented and distributed the DAFNE Special Issue recently published in the jurnal f Public Health Nutritin and she encuraged participants t submit abstracts and papers, in accrdance t the already decided publicatin strategy. Participants finally presented tables and graphs with findings, n their cuntry fd availability f the 15 main fd grups, fr the verall ppulatin and fr sciecnmic grups f the ppulatin. In the light f the preliminary findings, sme amendments in the cntent f the natinal reprts were prpsed and apprved. 24

25 Bilateral Meetings The fllwing five bilateral meetings tk place in the curse f the DAFNE III prject: Meeting between Prtugal and the Athens crdinating centre (Athens, July 2000) Meeting between Italy and the Athens crdinating center (Athens, January 2001) Meeting between Belgium and the Athens crdinating centre (Athens, April 2001) Meeting between Nrway and the Athens crdinating centre (Athens, Nvember 2001) Meeting between Belgium and the Athens crdinating centre (Athens, May 2002). Bilateral meetings were scheduled in rder t deal with cuntry-specific issues related t data reading and integrating, t the applicatin f the classificatin schemes, t data analysis and, in ne ccasin, t the preparatin f a manuscript n mnitring the dietary chices f elderly husehlds. 25

26 Activities f the DAFNE III prject The DAFNE Special Issue Public Health Nutritin Jurnal In 2001, a Supplement t the Octber Issue f Public Health Nutritin was published, devted t the DAFNE initiative. In Annex VII, the table f cntents f the Special issue is included. Suggestin n the COICOP-HBS Cding System. The COICOP-HBS cding system is applied by EUROSTAT fr the presentatin f fd data in the cntext f the natinal husehld budget surveys. All EU cuntries are asked t prvide their natinal data in accrdance t this scheme. In the cntext f revising the COICOP-HBS System undertaken by a EUROSTAT Task Frce, the DAFNE team prepared a wrking dcument including cmments n the current versin f the COICOP-HBS cding system and a wrking table summarizing the DAFNE prpsal fr ptential mdificatins in the COICOP System and infrmed EUROSTAT accrdingly. The prpsal is included in Annex VIII. Assessment Study f the DAFNE database by the CAP-GEMINI Grup An assessment study n the DAFNE database tk place in June 2002, as a first step twards pssible integratin in HIEMS. The fllwing tasks were carried ut during the assessment prcess: Analysis f the existing situatin. Clarify and dcument the pssible integratin f the database that was develped in the cntext f the Eurpean fd availability databank based n husehld budget surveys the DAFNE III prject (SI ) in HIEMS. Define cnclusins and recmmendatins cncerning the pssible integratin f the DAFNE database int HIEMS. The CAP Gemini Grup wh was respnsible fr the assessment study cncluded that it is technically feasible t integrate the DAFNE database in the HIEMS applicatin. A temprary shrt-time slutin fr making the DAFNE data available t the HIEMS user culd be t create a hyperlink in HIEMS t the DAFNE prject 26

27 Website. This wuld als be a new functinality in HIEMS ( Disseminatin f research results Scientific papers Lagiu P, Trichpulu A and the DAFNE cntributrs. The DAFNE initiative: the methdlgy fr assessing dietary patterns acrss Eurpe using husehld budget survey data. Publ Health Nutr. 2001; 4(5B): Trichpulu A and the DAFNE cntributrs. The DAFNE databank as a simple tl fr nutritin plicy Publ. Health Nutr. 2001; 4(5B): Rdrigues SSP and MDV de Almeida Prtuguese husehld fd availability in 1990 and 1995 Publ Health Nutr. 2001;4(5B): Antnia Trichpulu, Andrniki Naska, Les habitudes alimentaires dans différents pays d Eurpe. Une analyse de la banque de dnnées DAFNE Echanges Santé (accepted, in press) Antnia Trichpulu, Andrniki Naska and Tina Cstacu, n behalf f the DAFNE III grup. Disparities in fd habits acrss Eurpe Prceedings f the Nutritin Sciety (accepted, in press). Antnia Trichpulu, Andrniki Naska, Anna Antniu, Sharn Friel, Kerstin Trygg and Aida Turrini. Vegetable and Fruit: The Evidence in their favur and the Public Health Perspective. Internatinal Jurnal f Vitamin and Nutritin Research (accepted, in press) 27

28 A summary f the DAFNE prject entitled The DAFNE initiative was included in the June/July 2000 issue f the Eurpean Public Health Update, the jurnal f the Eurpean Public Health Alliance. Cnference presentatins Oral presentatins Τrichpulu A. The DAFNE (Data Fd Netwrking) databank. A tl fr mnitring trends in fd habits in Eurpe. Prceedings f the Eurdiet Cnference n Nutritin & Diet fr Healthy Lifestyles in Eurpe: Science & Plicy Implicatins, Heraklin, May Public Health Nutritin 2001; 4:1:106. Trichpulu A, Naska A, Remaut A.M, Cuert Eulert A.P, Lenhauser I.U, Zajkas G, Friel S, Daltn J,Schmitt A, Trygg K, Mrk E, Sekula W, Mreiras O, Nelsn M, Rimmer D. The DAFNE Databank as a tl fr mnitring disparities in meat availability in Eurpe. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds).Vienna, August Ann Nutr Metab 2001; 45 (suppl 1): 549. Friel S, Kelleher C, Trichpulu A, Naska A, Vasdekis V. Scial variatin in Irish dietary habits: Husehld and individual evidence. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):549 Perez Cuet Eulert F, Remaut-De Winter A.M, Naska A. Preliminary results f changes in fd and nutrient availability at husehld level in Belgium. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):549. Trichpulu A, Naska A. Disparities in fd habits acrss Eurpe. Abstacts f the Meeting n Influence f Scial and Cultural Variatins n Diet, summary 04. Infrmatin Technlgy Building, Natinal University f Ireland Galway, June 2002 Trichpulu A, fr the DAFNE team. The use f husehld budget survey data fr assessing fd disparities within and between ppulatins-case 28

29 studies f 13 Eurpean cuntries. Abstracts f the 3 rd sessin f the Internatinal Scientific Sympsium n Measurement and Assessment f Fd Deprivatin and Under-nutritin. FAO Headquarters. Rme, June 2002 (ral presentatin). Pster presentatins Friel S, Kelleher C, Trichpulu A and Naska A. Scial variatin in Irish Husehld and Individual Dietary Habits. Abstracts Bk f Fd and Nutritin fr better heath. A Eurpean Cnference: highlights frm EC research prgrammes (HEALFO Cnference) p Santa Maria Imbar- Lancian, June Rdrigues S.S.P and de Almeida MDV. Prtuguese Husehld Fd Availability between 1990 and Abstracts Bk f Fd and Nutritin fr better heath. A Eurpean Cnference: highlights frm EC research prgrammes (HEALFO Cnference) p Santa Maria Imbar-Lancian, June 2001 Remaut-De Winter A.M, Perez Cuet Eulert F, Naska A, Trichpulu A. Cnverting Fd Purchases in quantities f available fd at husehld level in Belgium. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):550 Paterakis S.E, Burr S, Nelsn M. Evaluatin f the natinal fd survey (NFS) Data fr epidemilgical purpses. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):550 Maffre J, Vlatier J.-L. An estimatin methd f quantities f fd availability in a husehld budget survey. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):549. Rdrigues S.P, de Almeida MDV.Gender differences in fd availability in elderly single husehlds: the DAFNE III Prguguese data. Abstracts f the 29

30 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):412 Barcherini S, Ceccarelli C, Martines S, Turrini A. Fd cnsumptin behaviur in Italian regins: An analysis f the 1996 HBS. Abstracts f the 17 th Internatinal Cngress f Nutritin. Elmadfa I, Knig J (Eds). Vienna, August Ann Nutr Metab 2001; 45 (suppl 1):

31 List f references 1. Deharveng G, Charrndiere UR, Slimani N, Suthgate DAT, Ribli E. Cmparisn f nutrients in the fd cmpsitin tables available in the nine Eurpean cuntries participating in EPIC. Eur.J.Clin.Nutr.1999; 53: Trichpuls D, Lagiu P. Dietary patterns and mrtality. Br.J.Nutr 2000 Feb; 85(2): Trichpuls D, Lagiu P, Trichpulu A. Evidence-based nutritin As.Pac.J.Clin. Nut.2000;9:S4-S9,Suppl. 4. Cstacu T, Bamia C, Ferrari P, Ribli E, Trichpuls D and Trichpulu A. Tracing the Mediterranean diet thrugh principal cmpnents and cluster analyses in the Greek ppulatin. Eur J Clin Nutritin (accepted, in press). 5. Verger P, Ireland J, Mller A, Abravicius JA, De Henauw S and Naska A fr the EFCOSUM Grup. Imprvement f cmparability f dietary intake assessment using currently available individual fd cnsumptin surveys. Eur. J Clin Nutr 2002; 56(Suppl2):S18-S Trichpulu A. Mnitring fd intake in Eurpe: A fd data bank based n husehld budget surveys. Eur.J.Clin.Nutr 1992: 46 (Suppl.5) : S3-S8 7. Trichpulu A and Naska A (editrs). The DAFNE Initiative. Assessment f dietary patterns acrss Eurpe using husehld budget survey data A Eurpean Cmmissin supprted prject. Public Health Nutr: 4(5B), Octber pp Trichpulu A, Lagiu P, Nelsn M, Remaut-De Winter AM, Kelleher C, Lenhauser IU, Mreiras O, Schmitt A, Sekula W, Trygg K, Zajkas G fr the DAFNE I and II prjects f the Eurpean Cmmissin. Fd disparities in 10 Eurpean cuntries: their detectin using Husehld Budget Survey data The DAta Fd NEtwrking (DAFNE) initiative. Nutritin Tday, 1999, May/June; 34:3: Byrd-Bredbenner C, Lagiu P, Trichpulu A. A cmparisn f husehld fd availability in 11 cuntries. J Hum Nutr Dietet. 2000; 13 : A. Naska V.G.S Vasdekis and A. Trichpulu. A preliminary assessment f the use f husehld budget survey data fr the predictin f individual fd cnsumptin. Public Health Nutritin Octber 2001; 4(5B):

32 11. Lagiu P, Trichpulu A and the DAFNE cntributrs. The DAFNE initiative: the methdlgy fr assessing dietary patterns acrss Eurpe using husehld budget survey data. Publ Health Nutr. 2001; 4(5B): Rs E, Prattala R, Lahelma E, Kleemla P, Pietinen P. Mdern and healthy?: Sciecnmic differences in the quality f diet. Eur. J. Clin Nutr. 1996;50:

33 List f Annexes Annex I: Annex II: Annex III: Annex IV: Annex V: Annex VI: Annex VII: Annex VIII: HBS data cllectin methdlgy Fd Aggregatin Tables Cmparable categries f sci-demgraphic data Mean daily individual availability f 15 main fd grups - Availability fr the verall ppulatin - Availability by lcality f the husehld - Availability by educatin f the husehld head - Availability by ccupatin f the husehld head - Availability by husehld cmpsitin Graphical presentatins f changes in fd availability ver time Minutes f the prject s plenary and bilateral meetings Table f cntents f the DAFNE Special Issue Prpsal t EUROSTAT fr the mdificatin f the COICOP-HBS Cdificatin System. 33

34 This reprt was prduced by a cntractr fr Health & Cnsumer Prtectin Directrate General and represents the views f the cntractr r authr. These views have nt been adpted r in any way apprved by the Cmmissin and d nt necessarily represent the view f the Cmmissin r the Directrate General fr Health and Cnsumer Prtectin. The Eurpean Cmmissin des nt guarantee the accuracy f the data included in this study, nr des it accept respnsibility fr any use made theref.